| Prime Medical Management | |
|
800 S Central Ave Ste 301 Glendale CA 91204-4388 | |
| (747) 215-8746 | |
| Not Available |
| Full Name | Prime Medical Management |
|---|---|
| Speciality | General Practice |
| Location | 800 S Central Ave Ste 301, Glendale, California |
| Authorized Official Name and Position | Karen Avetisyan (CEO) |
| Authorized Official Contact | 7472158746 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Medical Management 800 S Central Ave Ste 301 Glendale CA 91204-4388 Ph: (747) 215-8746 | Prime Medical Management 800 S Central Ave Ste 301 Glendale CA 91204-4388 Ph: (747) 215-8746 |
| NPI Number | 1821960352 |
|---|---|
| Provider Enumeration Date | 09/23/2025 |
| Last Update Date | 09/23/2025 |
| Certification Date | 09/23/2025 |
| Medicare PECOS PAC ID | 8325544083 |
|---|---|
| Medicare Enrollment ID | O20251001002429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821960352 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| Provider Name | Edik Avetyan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437771276 PECOS PAC ID: 5294172631 Enrollment ID: I20240321001713 |
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